title: Immune response to pneumococcus and tetanus toxoid in patients with moderate-to-severe psoriasis following long-term ustekinumab use.
abstract: BACKGROUND
  Little is known about the impact of long-term use of immunosuppressive agents on immune response.
  
  
  OBJECTIVE
  Assess the impact of continuous maintenance ustekinumab treatment on patients' ability to mount immune responses to pneumococcal (T-cell-independent) and tetanus toxoid (T-cell-dependent) vaccines.
  
  
  METHODS
  Ustekinumab-treated patients with moderate-to-severe psoriasis treated in the long-term extension of the Phase 3 PHOENIX 2 trial (n=60) were compared with control psoriasis patients not receiving systemic therapy (n=56). Patients were vaccinated with both 23-valent pneumococcal and tetanus toxoid vaccines. Serum samples collected pre-vaccination and 4 weeks post-vaccination were assessed for antibody responses.
  
  
  RESULTS
  No differences in the ability of ustekinumab-treated patients to respond to pneumococcal or tetanus toxoid vaccinations were observed compared with controls. A ≥2-fold increase in antibody levels in ≥7 of 14 serotypes of the pneumococcal vaccine was observed in ustekinumab-treated (96.6%) and untreated control (92.6%) patients following vaccination. Ustekinumab-treated patients achieved a ≥4-fold increase (84.7%) in anti-tetanus antibody vs. 77.8% in the control group. No differences were detected in ex-vivo responses to anti-CD3/CD28 or tetanus toxoid between ustekinumab-treated and control groups.
  
  
  CONCLUSIONS
  Long-term treatment (≥3 years) with ustekinumab does not compromise the immune response to T-cell-dependent/-independent vaccines in patients with moderate-to-severe psoriasis.
authors.forename: Carrie
authors.initials: C
authors.lastname: Brodmerkel
authors.forename: Eric
authors.initials: E
authors.lastname: Wadman
authors.forename: Richard G
authors.initials: RG
authors.lastname: Langley
authors.forename: Kim A A
authors.initials: KA
authors.lastname: Papp
authors.forename: Marc
authors.initials: M
authors.lastname: Bourcier
authors.forename: Yves
authors.initials: Y
authors.lastname: Poulin
authors.forename: Vincent
authors.initials: V
authors.lastname: Ho
authors.forename: Lyn
authors.initials: L
authors.lastname: Guenther
authors.forename: Rod
authors.initials: R
authors.lastname: Kunynetz
authors.forename: Simon
authors.initials: S
authors.lastname: Nigen
authors.forename: Ronald
authors.initials: R
authors.lastname: Vender
authors.forename: Norman
authors.initials: N
authors.lastname: Wasel
authors.forename: Ming-Chun
authors.initials: MC
authors.lastname: Hsu
authors.forename: Philippe
authors.initials: P
authors.lastname: Szapary
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000276:immunology; D011565:Psoriasis / Q000188:drug therapy / Q000276:immunology*; D013296:Streptococcus pneumoniae / Q000276:immunology*; D013745:Tetanus Toxoid / Q000276:immunology*; D000069549:Ustekinumab; D014611:Vaccination
chemical_list: D000906:Antibodies; D061067:Antibodies, Monoclonal, Humanized; D022242:Pneumococcal Vaccines; D013745:Tetanus Toxoid; D000069549:Ustekinumab